Letter to President Bush on 2006 State of Union Address

February 1, 2006

George W. Bush President, United States of America The White House 1600 Pennsylvania Avenue Washington, DC 20500

Dear Mr. President:

Congratulations on your State of the Union address. As associations that work on both a national and international basis we couldn't agree more with your comments regarding America as a leader and a nation that must take part in the world community.

The American Medical Informatics Association (AMIA) and the American Health Information Management Association (AHIMA) are pleased with your continued attention for the need to expand the use of electronic health records (EHR). We strongly agree that EHRs will improve the quality of care, reduce medical injuries, and lower the cost of healthcare administration. We also want to acknowledge the leadership your administration has provided to the healthcare industry as we move through the changes necessary to achieve the goals you established a few short years ago.

Mr. President, while we are making measurable progress, AHIMA and AMIA believe there are a few key actions that with your vocal and active support can accelerate the adoption of a nationwide system of interoperable EHRs. Your assistance in promoting these recommendations to policymakers and the public would be a strong incentive for more rapid progress and tangible benefits:

Increase support and efforts to formally adopt EHR standards for use in the healthcare industry that ensure a complete, legal, and uniform health record. These standards are essential to achieving the goal of interoperable use of secondary health information you have espoused in your last three State of the Union addresses.

Accelerate efforts to upgrade and ensure the coordination of health information data standards including classifications, terminologies, and vocabularies. Such action should include:

Continuance of the SNOMED-CT® contract for a clinical terminology that will serve as the foundation for the standard EHR, and expanded for availability as Medline is today,

The immediate adoption of upgrades to the ICD-9-CM classification system to ICD-10 with an implementation deadline no later than 2009, and

Additional funding for the National Library of Medicine to ensure that approved vocabulary and other data content standards are maintained, coordinated, and updated regularly to ensure appropriate alignment and uniformity within the sets of approved standards for the EHR and a nationwide health information network.

These actions will not only serve to provide national adoption of EHRs but also support your administration's efforts to improve biosurveillance, improve healthcare quality, and keep America competitive with the rest of the industrialized nations that have already taken similar steps.

Actively call for the House to pass S. 306, the "Genetic Information Nondiscrimination Act," as a step to convincing the American public that they have nothing to fear in the adoption and use of electronic health records and nationwide health information networks.

Support increased funding for education and training in healthcare informatics and information management. It will take an increasingly large, educated, and diverse workforce to ensure proper management and use of electronic health systems and networks. These highly skilled 21st century healthcare workers are needed to ensure that we can convert the volumes of data such systems and networks will provide into useful knowledge applicable to improving quality, reducing medical injuries, increasing health research information and information to improve coverage and lower costs, and biosurveillance and public health monitoring for outbreaks such as pandemic flu.

All these actions will accelerate the use of electronic health records, improve the health and healthcare of this nation and reduce costs. AMIA and AHIMA look forward to continuing to work with your administration and Congress to achieve the goals you have set forth. If we can respond to any questions or concerns you have regarding this letter, please feel free to contact us at the addresses below. You may also contact Dan Rode, vice president for policy and government relations in our Washington, DC office at 202-659-9440 or dan.rode@ahima.org.